Laborers Local 252

Summary of Dental Benefits

Benefit Category

Co-Pay

Office Visit $15.00
Emergency Treatment (After Hours) $25.00

Diagnostic/Routine/Preventative/Basic Services

Exams, Cleaning, Fluoride Treatments, X-Rays, Sealants, Space Maintainers, Periodontal scale/prophy, minor restorations No Co-Pay

Oral Surgery

Routine extractions No Co-Pay
Extractions soft tissue, partial and full bony impaction (per tooth) $100.00

Prosthetics

Stainless Crown, primary No Co-Pay
Metal or porcelain crowns or 3/4 crowns $250.00
Upper or lower dentures, full or partial $300.00

Endodontics

Anterior root canal $75.00
Bicuspid root canal $150.00
Molar root canal $225.00

General Anesthesia

First 30 minutes $100.00

Orthodontics

Class 1, Class 2 and Class 3 $2800.00

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